Mary Lou Peck, FNP is a
Nurse Practitioner - Family based in Averill Park, New York. Mary Lou Peck is licensed to practice in New York (license number F3308081) and her current practice location is
196 Vosburgh Rd, Averill Park, New York. She can be reached at her office (for appointments etc.) via phone at
(518) 892-8591.
NPI number for Mary Lou Peck is 1174759534 and her current mailing address is 196 Vosburgh Rd, Averill Park, New York. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1174759534.
Provider's Profile
| Full Name | Mary Lou Peck |
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| Gender | Female |
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| Speciality | Nurse Practitioner - Family |
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| Location | 196 Vosburgh Rd, Averill Park, New York |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1174759534
- Provider Enumeration Date: 05/29/2009
- Last Update Date: 05/29/2009
Medical Identifiers
Medical identifiers for Mary Lou Peck such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1174759534 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 363LF0000X | Nurse Practitioner - Family | F3308081 (New York) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mary Lou Peck is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Mary Lou Peck, FNP
196 Vosburgh Rd,
Averill Park, NY 12018-5710
Ph: (518) 892-8591 | Mary Lou Peck, FNP
196 Vosburgh Rd,
Averill Park, NY 12018-5710
Ph: (518) 892-8591 |
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